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Smallpox of monkeys and vaccine: what Bassetti, Galli and Gismondo say

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The multiplication of cases of monkeypox around the world could trigger the WHO declaration of international emergency in the next few hours. Meanwhile, to deal with the virus, some countries such as Spain are thinking of re-proposing human smallpox vaccination, a move that however does not convince the experts in our house. Galli – “It would make no sense to go back to the smallpox vaccine. There is no need now. I think the matter can be handled differently. The cost-benefit ratio is not such as to reintroduce a vaccine which, by the way, is not a free walk: it has a number of side effects. And the risk of these effects, balanced with the risk of getting the infection, makes me say that getting vaccinated is absolutely not worth it. ” Massimo Galli, former director of the infectious diseases department of the Sacco hospital in Milan, said this at Adnkronos Salute about the usefulness of reintroducing vaccination against smallpox as a protection from the virus at the origin of the recent infections reported in the world, and against which vaccinated people seem to have greater protection. For Galli, on the other hand, “it is important to go and see where this infection starts. And to follow contacts very carefully. In this way, the affair should be closed in a reasonable time. I really hope that is the case. If something is not missing, if things are done well, we should have no major problems except a further warning that nature must be handled with care. We must multiply the attention on health risks “. Raising monkeypox to an international emergency? “I believe that the hypothesis of the World Health Organization is a due act, until a further clarification of the situation. We certainly cannot let a phenomenon with these characteristics pass without working on it, even if there are no elements of an alarm”, claims the infectious disease specialist. “In order to quickly resolve this phenomenon, as we all hope – he concludes – we need to manage things in the best possible way and the health emergency tool also serves to alert the health systems of all countries”. Bassetti – “We cannot say to the population ‘from tomorrow we will vaccinate you against smallpox’, because it would mean that we are facing an emergency. We can possibly evaluate immunization against smallpox on health workers and on some categories at risk, if there is one. I am. But it is not the time to extend vaccination. Let’s wait how the cases evolve and then we will decide “. So at Adnkronos Salute Matteo Bassetti, director of Infectious Diseases of the San Martino Polyclinic in Genoa, returns to the possibility of resuming anti-smallpox vaccinations, given the cases of monkeypox also in Italy. While the raising of the emergency level decided by the WHO “is correct for an awareness of the whole health and medical world in the world, Bassetti asserts – if you have a suspected case you must know how to recognize it. This allows us to first identify the infections, isolate them and intervene in the correct way “. Lopalco – “The declaration of an emergency public health event of international importance is a technical fact. If an emerging infectious disease crosses the borders of several states, the World Health Organization is required to intervene with coordination actions. For example by imposing mandatory reporting of cases “. The epidemiologist Pier Luigi Lopalco, professor of Hygiene at the University of Salento, explains this to Adnkronos Health about the possibility that the WHO classifies monkeypox as an international emergency. “In any case, there are criteria for declaring an international emergency, technically defined with the acronym Pheic, and that is what the WHO adheres to”. As for the hypothesis of re-proposing the vaccine against smallpox, according to Lopalco “extensive vaccination makes no sense. This is because it is not a widespread disease; the probability of spread is low, moreover the clinical severity is not such as to cause too much concern for the public health”. For Lopalco, in any case, “the availability of the vaccine can only be useful when there has been a probable exposure to a confirmed case”. Gismondo – “Paying attention to any virus that amplifies its range is absolutely right and, as Covid taught us, doing it quickly is even more important. But people need to know that we are not acting against a possible pandemic, nor should we to associate monkeypox with human smallpox “. Maria Rita Gismondo, director of the Laboratory of clinical microbiology, virology and bio-emergency diagnostics at the Sacco hospital in Milan, explains this to Adnkronos Salute. The ‘monkeypox’ is in fact “a pathology fortunately much less serious. Cases of this infection, in small numbers, have also occurred in the past and usually – recalls the microbiologist – these micro-epidemics are self-limited”. “If the World Health Organization declares monkeypox an international public health emergency, I really believe it will because on Covid it was instead accused, and rightly so, of delays with a lack of coordination at least in the initial stages of the pandemic.” An eventual Pheic (Public Health Emergency of International Concern) statement, the expert underlines, “could be useful to favor a univocal action against this virus and immediately limit its spread”.

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